Demyelinating Treatment used for Dental problem?

[nerve damage]

I have damage to my Inferior Alveolar nerve (left side, next to last molar, #18) due to a chemical burn from a botched root canal.  The filling material that came in contact with my IAN contained (para)formaldehyde.  I had the material removed and the nerve decompressed 2.5 months after it happened.  1 year after the root canal I continue to suffer from burning pain in my bottom lip and chin. The only med I have found that even takes the edge off is Elavil...50mg 3x day.

Are there any treatments that are used for demyelinating or other neurological diseases that could help repair or replace the nerve sheathing?  The surgeon explained the damage to me as an area of sheath that did not glisten.  It is approximately a 4-5mm sectionthat is damaged.

I am contemplating having a nerve graft or other surgery that will ultimately remove the damaged section but I wanted to explore other possiblities.  Unfortunately, with a nerve block I can still feel the pain in my lip.  I did not feel my chin.

I've been given different conflicting opinions about whether I am too far out from any repair surgery to get any benefit and could make it worse.  

I replaced Elavil with another drug and about a week later I was in the worst pain that I have ever been in in my entire life.  Those elavil tables are miracle workers but they do not eliminate the pain, just make it tolerable.  I don't think that it could get worse, unless the elavil stopped working.

Thank you.

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
   Pain related to nerve damage is often difficult to treat.  The main line of treatment is medications that are effective for neuropathic pain (elavil is a good choice), others include neurontin, lyrica, tegretol, effexor, etc.  Medications are expected to help reduce the pain to a tolerable level, but rarely remove the pain altogether.  Nerve blocks are a common first effor to achieve pain control and ganglion block (nerve terminal) is also used frequently.  RF ablation is a more effective means controlling the pain, but also results in permanent numbness in the area.  Gamma knife is similar.  I would suggest a consult to a pain management group to discuss your options.

[Jolier]

I am interested to know whether you have any side effects from the dosage and frequency of the Elavil. I find I have difficulty getting up from sitting without wobbling all over the place, I am often dizzy and these symptoms are not related to hypo/hypertension Hope you get some helpful advise.

[nerve damage]

I started off at 25mg 3x day.  I couldn't keep my eyes open for 3-4 days.  I adjusted to it enough that I could function but I had trouble staying awake at work.  I slowly upped my dosage and for awhile settled out at 25mg in morn, 25 in aft, and 50 at night.  i kept wanting to up it because my lip was still bothering me alot but the doctors didn't want me to.  I don't remember how I upped it from there but I eventually ended up taking 50mg 2x a day and then 25mg the third dose.  Although I could function, I still had problems staying awake and literally would fall asleep at my desk.  if I managed to stay awake all day at work, then as soon as I sat down on the couch I'd fall asleep.  There were MANY days when I went to bed at 6pm and didn't get up until 6am.  I gained a bunch of weight (didn't need any help), got tired of sleeping all the time, and tired of the dry mouth.  I went off of it, substituted Klonopin for it and then on Lamictal.  After about a week or so the elavil got out of my system and I went wacko on the lamictal emotionally and then spiraled out of control from massive pain.  I couldn't find those elavil tablets fast enough.  I started ramping back up and then finally took 50mg 3x day.  i pretty much used my burning lip and chin as my alarm clock on when to take the next dosage.  For some unknown reason, I havent had the sleepiness on the current dose that I am taking, which is more than when I went off of it.  I guess my body and brain realized what the alternative was...PAIN.  It really has been a miracle drug for me and nothing else that I've tried (lyrica, neurontin, trileptal, klonopin, lamictal) had any effect on my pain.  If the elavil ever stops working I don't know what I'll do.  It was unlivable pain.

[jcverive]

I have dealt with occipital neuralgia for the last 13 years, and have researched and taken almost every drug out there. I am not aware of any treatment to restore myelin.

Elavil was effective at reducing the pain, but the side effects were too much to deal with. If the side effects bother you, ask your doctor about Pamelor (nortriptyline), which is the metabolized form of Elavil.  It should work just as well as Elavil (amitriptyline), possibly even at a lower dosage.  You might also want to look into Cymbalta, or Keppra in combination with Cymbalta or the 'triptylines.

I wish you well. Nerve pain is a living hell.